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Record W4406954701 · doi:10.1093/ofid/ofae631.2113

P-1954. Wastewater-Based Surveillance More Accurately Describes Disease Burden Of COVID-19 In Communities with Less Than 60,000 Inhabitants – An Ontario-Wide Study

2025· article· en· W4406954701 on OpenAlexaffabout
Nada Hegazy, Katy Peng, Joan Hu, C. B. Dean, Elizabeth Renouf, Robert Delatolla

Bibliographic record

VenueOpen Forum Infectious Diseases · 2025
Typearticle
Languageen
FieldMedicine
TopicSARS-CoV-2 detection and testing
Canadian institutionsUniversity of WaterlooSimon Fraser UniversityUniversity of Ottawa
Fundersnot available
KeywordsMedicineCoronavirus disease 2019 (COVID-19)Disease burdenDisease surveillance2019-20 coronavirus outbreakSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)PandemicBurden of diseaseEnvironmental healthDiseaseGerontologyVirologyOutbreakInfectious disease (medical specialty)Pathology

Abstract

fetched live from OpenAlex

Abstract Background The emergence of COVID-19 in Canada prompted extensive efforts in population-wide surveillance, including wastewater-based surveillance (WBS). WBS offers insights into the prevalence of infectious disease burden, however, reasons for poor correlation between hospital admissions and wastewater viral signal in some locations across Ontario remain unclear, while others demonstrate remarkable correlations. This study aims to elucidate the parameters influencing hospitalization-WBS correlation quality to guide infectious disease research and surveillance.Figure 1:Geographic overview of sampling locations in Ontario, Canada Methods Wastewater viral signals and daily hospital admissions geospatially linked with the surveyed sewersheds, were obtained from the Ontario Wastewater Surveillance Initiative. The study included 94 sampling sites (Figure 1), excluding those with inadequate sampling frequency. Spearman’s rank correlation coefficient (ρ) was calculated between hospital admissions and wastewater signals for all included sites during the Omicron BA.1 and BA.2 waves from Nov. 1st,2021 to Jun. 30th, 2022. Regression trees were constructed using the R packages “rpart” and “rpart.plot” to identify factors influencing hospitalization-WBS ρ, including population size, hospital admissions range, proportion of zero admissions, and site isolation status.Figure 2:Regression trees representing a classification model for evaluating the correlation quality between hospitalizations and wastewater signal during the Omicron BA.1 wave – coinciding with a period of waned vaccination immunity (A) and the Omicron BA.2 wave – coinciding with a period of significant vaccination immunity (B). Results Regression tree analysis identified critical population size thresholds influencing hospitalization-WBS ρ: populations under 66,000 exhibited weaker ρ (ρ > 0.650) during Omicron BA.1, and under 187,000 during the BA.2 wave (Figure 3). Larger population areas exhibited stronger hospitalization-WBS ρ, suggesting both are reliable infectious disease burden indicators, influenced by differences in community immunity dynamics between the two waves. Conclusion Populations under 66,000 during a period of waned vaccine immunity and under 187,000 during a period of significant vaccine immunity exhibit distinct relationship between hospital admissions and wastewater signals. These thresholds mark key sizes of communities where the efficacy of wastewater surveillance becomes more pronounced, emphasizing its utility in smaller populations where clinical surveillance of infectious diseases may be limited. Disclosures All Authors: No reported disclosures

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.250
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.001
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.064
GPT teacher head0.348
Teacher spread0.283 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2025
Admission routes2
Has abstractyes

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